Normal Vaginal Delivery in a Persistent Vegetative State: Suggestive Management, a Case Report and Literature Review

Abstract

10.30699/jogcr.7.5.462 Severe injury to the nervous system in pregnancy needs advanced critical care support to the mother and consideration of fetal effects. Managing persistent vegetative state (PSV) cases in pregnant patients is complex due to the lack of clear guidelines for medical and ethical reasons. This reports a gravida 4, maternal persistent vegetative state case due to a car accident for a 25-year-old woman at 20 pregnancy weeks. Aggressive support enabled the continuation of pregnancy toward 3th trimester without any impediment to the infant's development. A fetal scan for growth monitoring showed an estimated fetal weight near the 75th centile. Intervention in the pregnancy of a patient suffering PSV is not required if both mother and fetus are stable. Maternal malnutrition may adversely affect the fetus and neonate. In this case, high caloric nutrition with partial parenteral nutrition was employed. We monitored both the mother and her child in an attempt to gather data pertinent to the appropriate care of pregnancy in a persistent vegetative state and the potential sequel for offspring.